糖尿病足溃疡感染病原菌及外周血SDF-1α、CXCR4、PCT和CRP表达  

Pathogens isolated from patients with diabetic foot ulcer infection and expressions of SDF-1α,CXCR4,PCT and CRP in peripheral blood

作　　者：许静 李绪香 李亚男 李维维 XU Jing;LI Xuxiang;LI Yanan;LI Weiwei(Jinan People's Hospital(Affiliated People's Hospital of Shandong First Medical University),Jinan,Shandong 271100,China)

机构地区：[1]济南市人民医院(山东第一医科大学附属人民医院)内分泌科,山东济南271100 [2]济南市人民医院(山东第一医科大学附属人民医院)皮肤科,山东济南271100

出　　处：《中华医院感染学杂志》2025年第6期862-866,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展基金资助项目(2021WS023)。

摘　　要：目的探讨糖尿病足溃疡感染病原菌及外周血基质细胞衍生因子-1α(SDF-1α)、趋化因子受体4(CXCR4)、降钙素原(PCT)、C-反应蛋白(CRP)表达,为临床诊疗糖尿病足溃疡感染提供依据。方法选取济南市人民医院2020年11月-2023年12月收治的172例糖尿病足溃疡患者,包括感染患者141例为感染组和无感染患者31例为非感染组。统计感染组病原菌和耐药性;比较两组外周血SDF-1α、CXCR4、PCT和CRP水平;分析四指标联合检测对糖尿病足溃疡感染的诊断价值。结果感染组检出152株病原菌中多为革兰阴性菌,检出大肠埃希菌、金黄色葡萄球菌和表皮葡萄球菌占比较高。大肠埃希菌耐药性强的是氨苄西林和哌拉西林;金黄色葡萄球菌、表皮葡萄球菌对青霉素、红霉素有高耐药性;感染组和非感染组血清SDF-1α、CXCR4、PCT和CRP水平比较,差异有统计学意义(P<0.05),其中感染组血清CRP水平为(15.25±4.65)mg/L高于非感染组的(10.97±3.42)mg/L(t=4.840,P<0.001)。四指标联合检测诊断糖尿病足溃疡感染的曲线下面积(AUC)比单独检测高(P<0.05),敏感度、特异度分别为85.80%、87.10%。结论糖尿病足溃疡感染多为革兰阴性菌,检出病原菌中大肠埃希菌、金黄色葡萄球菌和表皮葡萄球菌较多,各病原菌耐药性有差异,对常用抗菌药物有较高耐药性。SDF-1α、CXCR4、PCT和CRP水平变化与糖尿病足溃疡感染有关,联合检测有助于对其进行诊断。OBJECTIVE To explore the distribution of pathogens isolated from the patients with diabetic foot ulcer infection and observe the expressions of stromal cell derived factor-1α(SDF-1α),chemokine receptor 4(CXCR4),procalcitonin(PCT)and C-reactive protein(CRP)in peripheral blood.METHODS A total of 172 patients with diabetic foot ulcer who were treated in Jinan People′s Hospital from Nov.2020 to Dec.2023 were enrolled in the study and were divided into the infection group with 141 cases and the non-infection group with 31 cases.The distribution and drug resistance of the pathogens were statistically analyzed.The levels of SDF-1α,CXCR4,PCT and CRP were compared between the two groups.The value of the joint detection of the four indexes in diagnosis of the diabetic foot ulcer infection was analyzed.RESULTS Gram-negative bacteria were dominant among 152 strains of pathogens isolated from the patients of the infection group.Escherichia coli,Staphylococcus aureus and Staphylococcus epidermidis were the predominant species.The E.coli strains were highly resistant to ampicillin and piperacillin;the S.aureus and S.epidermidis strains were highly resistant to penicillin and erythromycin.There were significant differences in the levels of serum SDF-1α,CXCR4,PCT and CRP between the infection group and the non-infection group(P<0.05);the serum CRP level of the infection group was(15.25±4.65)mg/L,higher than(10.97±3.42)mg/L of the non-infection group(t=4.840,P<0.001).The area under the curve(AUC)of the joint detection of the four indexes was higher than that of the single detection in diagnosis of the diabetic foot ulcer infection(P<0.05),with the sensitivity 85.80%,the specificity 87.10%.CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the patients with diabetic foot ulcer infection.E.coli,S.aureus and S.epidermidis are the predominant species.The pathogens vary in the drug resistance and are highly resistant to the commonly used antibiotics.There is association between the changes of

关 键 词：糖尿病足溃疡 感染 病原菌 耐药性 基质细胞衍生因子-1Α 趋化因子受体4 降钙素原 C-反应蛋白 

分 类 号：R587.2[医药卫生—内分泌]